Understanding Depression

Depression is a serious medical condition with a variety of emotional, cognitive, physical and behavioural symptoms.^2‐4

Emotional symptoms can include sadness, loss of interest in things you once enjoyed, thoughts of death or suicide, feelings of guilt or worthlessness, trouble concentrating or making decisions, and anxiety.^2‐4

Physical symptoms can include aches and pains, restlessness, lack of energy, and changes in weight, appetite, or sleep patterns.^2‐4

Some people go to their doctor complaining about tearfulness, excessive worry over physical health, brooding, fatigue, irritability, and complaints of pain (e.g., headaches, joint pain, stomach pain or other pains) These people may be suffering from depression.^2‐4

There are many theories about the cause of depression. One common theory is that depression is caused by an imbalance of naturally occurring substances called neurotransmitters in the brain and spinal cord.¹²

Neurotransmitters help transport messages between nerve cells.¹³ Serotonin and norepinephrine and dopamine are examples of these neurotransmitters.¹²

In the brain, serotonin and norepinephrine are thought to be associated with mood as well as regulating and reducing feelings of pain that come from the body.¹⁰ Dopamine is thought to be associated with appetite, loss of pleasure and energy or drive.⁸

Typically, more women experience depression than men.⁵ Potential explanations may relate to biological, psychological or social factors or to a combination of them.¹⁴ While research has shown hormones have a direct effect on the brain chemistry that controls mood, scientists are still unsure why some women develop depression and others do not.¹⁵

Your primary care physician or a psychiatrist can provide a comprehensive treatment plan—seeing a healthcare professional is one of the first steps toward dealing with depression. Before diagnosing you with depression, the doctor will do a complete diagnostic evaluation. This evaluation may include an assessment of your physical health, an assessment of your psychosocial status (including social and interpersonal relationships) and as assessment of any other mental health conditions you may also have. Assessment of past treatment and how you did or did not respond is also important and can help guide treatment decisions. Information from other sources such as your health records and speaking to those who know you is often a key component of an assessment.⁵

Your doctor will also have to assess whether you have experienced, during the same 2-week period, depressed mood or a loss of pleasure in addition to five (or more) of the following symptoms and that these symptoms represent a change from previous functioning:²

(1) Depressed mood most of the day, nearly every day.

(2) Significant loss of interest or pleasure in all, or almost all, activities most of the day, nearly every day.

(3) Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day.

(4) Insomnia or hypersomnia nearly every day.

(5) Psychomotor agitation (e.g., the inability to sit still, pacing, hand-wringing; or pulling or rubbing of the skin, clothing, or other objects) or retardation (e.g., slowed speech, thinking, and body movements; increased pauses before answering; speech that is decreased in volume, inflection, amount, or variety of content, or muteness) nearly every day.

(6) Fatigue or loss of energy nearly every day.

(7) Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day.

(8) Diminished ability to think or concentrate; or indecisiveness, nearly every day.

(9) Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

In addition your doctor will have to determine whether or not these symptoms have caused clinically significant impairment in social, occupational or other important areas of functioning. He or she will also have to rule out that the symptoms were the result of the use of a substance or of a medical condition. Your doctor will also have to make sure that if you have experienced the loss of a loved one that your symptoms are not better explained by this loss.²

Once a healthcare professional has diagnosed you with depression, they may recommend a number of treatment options.

Questions to ask your healthcare provider include:

• Do I need counselling? If so, can you recommend someone?
• Are there any self-help strategies or lifestyle changes you'd recommend?
• For a complete list of questions, see Talk to your Doctor.

It's important to take that first step in getting help for depression as soon as possible. Depression is an illness that can, and should, be treated.¹

Talk to a loved one or a friend today about how you are feeling so they may help you talk with a doctor.

Learn more about:

• Taking the First Step
• Talking to Friends and Family
• Questions to Ask Your Doctor